October 2020



516581123431500598201722923500October 2020Women’s Sector Resilience FundApplication FormPlease refer to the application guidance notes before filling this form out.Successful applications will be decided on an ongoing basis. Please submit your application as soon as possible. Please note DCMS require all onward funding to be spent by 31st March pleted applications and supporting documents should be emailed to grants@.uk. If you have any questions on the application process or guidance notes please email grants@.uk.1. Details of your organisationName of your organisation: FORMTEXT ?????Legal status: FORMTEXT ?????VAT Registration No. (if applicable): FORMTEXT ?????Charity Registration No. (if applicable): FORMTEXT ?????Company Registration No. (if applicable): FORMTEXT ?????Contact name/job title for enquiries about this application FORMTEXT ?????Contact number: FORMTEXT ?????Email address: FORMTEXT ?????Organisation address: FORMTEXT ?????Organisation post code: FORMTEXT ?????Website: FORMTEXT ?????A brief description of theorganisation’s purpose(maximum word limit: 30) FORMTEXT ?????2. Information required by DCMSTick which ONE best describes the type of service your organisation provides?Please tick one(continued on page 2)Connect with older women FORMCHECKBOX Connect with women with a disability FORMCHECKBOX Provide advice and support to those pushed into crisis FORMCHECKBOX Supporting those in medical or end of life care FORMCHECKBOX Providing essential items FORMCHECKBOX Supporting women experiencing health inequalities FORMCHECKBOX Supporting women who experience loneliness and social isolation FORMCHECKBOX Supporting women who experience poor mental health FORMCHECKBOX Supporting children and young women to achieve their potential FORMCHECKBOX Supporting local community activity, including volunteering, and community organising FORMCHECKBOX Supporting community and sector infrastructure, including public information FORMCHECKBOX Supporting digital, data and technology capabilities FORMCHECKBOX Supporting food supply FORMCHECKBOX Supporting homelessness FORMCHECKBOX Supporting gender equality FORMCHECKBOX Supporting survivors of domestic abuse FORMCHECKBOX Supporting refugees FORMCHECKBOX Other, please specify FORMTEXT ?????Will your funding support BAME women/groups?Yes FORMCHECKBOX No FORMCHECKBOX Will your funding support LGBT+ women/groups?Yes FORMCHECKBOX No FORMCHECKBOX Will your funding support women with a disability? Yes FORMCHECKBOX No FORMCHECKBOX Which best describes they type of funding you are applying for, please tick one:Please tick oneGrant to support organisations providing services and support for vulnerable women, for which there is increased demand as a result of the Covid-19 crisis FORMCHECKBOX Grant to support organisations supporting women who experience disproportionate challenge and difficulty as a result of the Covid-19 crisis FORMCHECKBOX Grant to support organisations which connects communities and support communities to work together to respond to Covid-19 FORMCHECKBOX Have you been awarded any or have applications pending for other Covid-19 emergency grant funding?Please note we cannot provide duplicate funding for the same job roles or activities. If you are unsure, please email grants@.ukIf yes, amounts and funder name:AwardedApplied for / awaiting decision FORMTEXT ????? FORMTEXT ?????3. Your financesIncome in last financial year ? FORMTEXT ?????Expenditure in last financial year? FORMTEXT ?????Level of free reserves ? FORMTEXT ?????Reserves?are the funds that your?organisation?has which can be freely spent on any of its purposes. This?definition?excludes restricted income funds and endowment funds as these must be spent in a specific way.?Reserves?will also normally exclude tangible fixed assets held for the?organisation’s own use.Please outline your current financial systems and governance including controls, processes and anti-bribery/anti-corruption measures. (150 words) FORMTEXT ?????4. Grant requestPlease describe what you are applying for funding. (250 words)The types of things the funding can support are:Staff salaries Project running costsRunning costs/overheadsGoods and equipment which would not be capitalised FORMTEXT ?????Please describe why you need these funds and how Covid-19 has impacted on your organisation. (250 words) FORMTEXT ?????What is your track record in supporting women and how have you demonstrated your impact? (150 words) FORMTEXT ????? FORMTEXT ?????How much are you applying for?? FORMTEXT ????? FORMTEXT ?????What will the money be spent on? Please list the following and a breakdown:Staff salaries Project running costsRunning costs/overheadsGoods and equipment which would not be capitalisedPlease note, all Smallwood funding must benefit women. If you are applying for funding for overheads or staff these must also only relate to your work/project activities/programmes with women. See next page for form.Budget heading/descriptionE.g. ?8,500 = 1 Support worker salary, 2.5 days per week x 24 weeks including on costs (employer’s national insurance, pension contributions etc.)Amount ?Total ? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Overall Total ? FORMTEXT ?????5. Your beneficiariesHow many women you expect to reach? FORMTEXT ?????Beneficiary target groups:Please tick all that apply and the groups that you predominantly work withBAME Women FORMCHECKBOX Women with disabilities FORMCHECKBOX LGBT+ women who are financially vulnerable FORMCHECKBOX Economically inactive young women FORMCHECKBOX Carers and those who have been working in the caring professions FORMCHECKBOX Single parent families FORMCHECKBOX Women who experience depression, anxiety and other mental health needs FORMCHECKBOX Women leaving the criminal justice system FORMCHECKBOX Women who have experienced domestic violence, economic abuse or sexual abuse FORMCHECKBOX Other (please state) FORMTEXT ?????6. Your PoliciesPlease confirm that you have the relevant and up to date policies and protocolsIf you do not have any particular policy, we may be able to help you develop these.PolicyYesNoif No, please provide detailsHealth and Safety FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Safeguarding (and appropriate DBS checks where necessary) FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Data Protection/Confidentiality FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Equal Opportunities and Diversity FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Safer Recruitment FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Code of Conduct FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Confidential Reporting FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Complaints FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????Risk register FORMCHECKBOX FORMCHECKBOX FORMTEXT ?????7. ReferencesPlease provide two referees who are independent to your organisation.Referees can include:Funders including trusts and foundationsCommissionersLocal governmentOther local public servants – police munity leadersReferee 1Name: FORMTEXT ?????Organisation: FORMTEXT ?????Job Title: FORMTEXT ?????Telephone: FORMTEXT ?????Email: FORMTEXT ?????How known: FORMTEXT ?????Referee 2Name: FORMTEXT ?????Organisation: FORMTEXT ?????Job Title: FORMTEXT ?????Telephone: FORMTEXT ?????Email: FORMTEXT ?????How known: FORMTEXT ?????8. DeclarationI declare that to the best of my knowledge, the information provided in this application is truthful and correct.I understand that the Trust may reject this application if there is a failure to answer all relevant questions fully or if false or misleading information is provided.I confirm that the Trust may share details contained within this application form and supporting documents with DCMS as part of the assessment and award process for this Fund. If your application is successful we will also share monitoring and evaluation information with DCMS. Signature: FORMTEXT ?????Name: FORMTEXT ?????Job Title: FORMTEXT ?????Date: FORMTEXT ?????Telephone number: FORMTEXT ?????IMPORTANTPlease don't forget to submit your supporting documents:A copy of your most recent latest audited or examined accounts Latest management accounts Safeguarding policy and protocolsIf you are NOT a registered charity:Written rationale (see guidance notes)Constitution/governing documentSubmit to grants@.ukAny questions email grants@.ukThank you ................
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